术前超声评估甲状腺乳头状癌淋巴结转移的价值及漏诊、误诊分析

The Value of Preoperative Ultrasound in Evaluating Lymph Node Metastasis of Papillary Thyroid Carcinoma and Analysis of Missed Diagnosis and Misdiagnosis

目的:浅析术前超声评估甲状腺乳头状癌(Papillary thyroid cancer,PTC)淋巴结转移的价值及漏诊、误诊。方法:回顾性分析本院2018年1月-2020年1月收治PTC患者90例,依据术后实施病理证实,淋巴结转移发生患者56例设为转移组,未发生患者34例设为未转移组。术前进行超声评估淋巴结转移发生患者59例,未发生患者31例。比较两组术前超声成像特征;再比较术前超声的诊断效能并分析漏诊、误诊率。结果:转移组纵横径比<2率(73.21%)高于未转移组(41.18%),转移组淋巴门的结构消失率(66.07%)大于未转移组(26.47%),转移组点状钙化率(75.00%)高于未转移组(14.71%),转移组阻力指数降低率(66.07%)大于未转移组(8.82%),转移组峰值的流速提升率(69.64%)大于未转移组(11.76%),转移组囊变率(30.36%)大于未转移组(5.88%);(P<0.05)。术前实施超声检查淋巴结转移灵敏度为91.07%,特异度为76.47%,Kappa值为0.687,漏诊率为8.93%,误诊率为23.53%。结论:术前行超声评估对PTC产生淋巴结的转移诊断具备较高灵敏度与特异度,漏诊率与误诊率较低,应用价值显著。

Objective:To analyze the value of preoperative ultrasound in evaluating lymph node metastasis of papillary thyroid cancer(PTC)and its missed diagnosis and misdiagnosis.Methods:A retrospective analysis of 90 patients with PTC admitted to our hospital from January 2018 to January 2020 was conducted.Based on postoperative pathological confirmation,56 patients with lymph node metastasis were set as the metastasis group,and 34 patients with no disease were set as the non-metastasis group.Preoperative ultrasound assessment was performed in 59 patients with lymph node metastasis and 31 patients without.Compare the preoperative ultrasound imaging characteristics between the two groups;then compare the diagnostic efficacy of preoperative ultrasound and analyze the missed diagnosis and misdiagnosis rate.Results:The ratio of aspect ratio<2 in the metastatic group(73.21%)was higher than that of the non-metastatic group(41.18%).The rate of loss of lymphatic hilum structure in the metastatic group(66.07%)was greater than that of the non-metastatic group(26.47%).(75.00%)is higher than the non-transferred group(14.71%),the resistance index reduction rate of the transferred group(66.07%)is greater than that of the non-transferred group(8.82%),and the peak flow rate increase rate of the transferred group(69.64%)is greater than that of the non-transferred group(11.76)%,the rate of cystic transformation in the metastatic group(30.36%)was greater than that in the non-metastatic group(5.88%);(P<0.05).The sensitivity of preoperative ultrasound examination for lymph node metastasis was 91.07%,the specificity was 76.47%,the Kappa value was 0.687,the missed diagnosis rate was 8.93%,and the misdiagnosis rate was 23.53%.Conclusion:The preoperative ultrasound evaluation has high sensitivity and specificity in the diagnosis of lymph node metastasis caused by PTC,and the missed diagnosis rate and misdiagnosis rate are low,and the application value is significant.